“我们正在做的工作比我们自己更重要”:一项对美国社区助产师的定性研究。

IF 3.4 2区 医学 Q1 DEMOGRAPHY
Perspectives on Sexual and Reproductive Health Pub Date : 2022-09-01 Epub Date: 2022-07-07 DOI:10.1363/psrh.12203
Paula M Kett, Marieke S van Eijk, Grace A Guenther, Susan M Skillman
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引用次数: 4

摘要

背景:以社区为基础的助产师在围产期为孕妇、跨性别男性和性别非二元个体提供支持,并提供解决卫生不平等问题的基本服务和专业知识,在美国,他们通常还承担着填补围产期保健系统空白的额外作用。尽管以社区为基础的助产师提供了好处,但很少有研究探索与工作相关的条件和压力源,以社区为基础的助产师的经验。为了解决这一差距,我们调查了个人社区助产师的工作经历、相关压力源和压力管理策略。方法:在这项定性描述性研究中,我们于2021年3月至6月对在美国服务不足的社区工作的自我认定为社区助产师的个人进行了18次访谈。我们分析访谈的主题,我们通过团队共识来定义和最终确定主题。结果:助产师报告了他们在解决围产期不平等问题的工作中参与的具体策略。他们还描述了面临的几个与工作有关的压力源,包括目睹对客户的歧视,在医疗环境中遭受歧视,以及在金融不稳定中挣扎。为了减轻这些压力和与工作相关的挑战,受访者表示,他们依赖于助产师的同伴支持,并重新与他们的工作动机联系起来。结论:以社区为基础的助产师提供基本服务和专业知识,解决围产期护理中的不公平和系统性差距。然而,在努力改善围产期健康的同时,助产师本身也在一个不公平的制度中提供公平的工作,政治或财政支持不足。需要增加补偿和系统支持,承认所提供服务的广度,以加强和维持这一围产期劳动力的关键部分。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
"This work that we're doing is bigger than ourselves": A qualitative study with community-based birth doulas in the United States.

Context: Community-based birth doulas support pregnant women, transgender men, and gender non-binary individuals during the perinatal period and provide essential services and expertise that address health inequities, often taking on additional roles to fill systemic gaps in perinatal care in the United States (US). Despite the benefits that community-based birth doulas provide, there is little research exploring the work-related conditions and stressors community-based doulas experience. To address this gap, we examined the work experiences, related stressors, and stress management strategies of individual community-based birth doulas.

Methods: In this qualitative, descriptive study we conducted 18 interviews in March through June 2021 with individuals who self-identified as community-based doulas working in underserved communities in the US. We analyzed the interviews for themes, which we defined and finalized through team consensus.

Results: The doulas reported engaging in specific strategies in their work to address perinatal inequities. They also described facing several work-related stressors, including witnessing discrimination against clients, experiencing discrimination in medical environments, and struggling with financial instability. To mitigate these stressors and job-related challenges, interviewees reported they relied on doula peer support and reconnected with their motivations for the work.

Conclusions: Community-based doulas provide essential services and expertise which address inequities and systemic gaps in perinatal care. However, as they work to improve perinatal health, doulas themselves are providing equity work amidst an inequitable system and with insufficient political or financial support. Increased compensation and systemic support which acknowledges the breadth of services provided is needed to strengthen and sustain this critical part of the perinatal workforce.

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来源期刊
CiteScore
5.10
自引率
3.40%
发文量
24
期刊介绍: Perspectives on Sexual and Reproductive Health provides the latest peer-reviewed, policy-relevant research and analysis on sexual and reproductive health and rights in the United States and other developed countries. For more than four decades, Perspectives has offered unique insights into how reproductive health issues relate to one another; how they are affected by policies and programs; and their implications for individuals and societies. Published four times a year, Perspectives on Sexual and Reproductive Health includes original research, special reports and commentaries on the latest developments in the field of sexual and reproductive health, as well as staff-written summaries of recent findings in the field.
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